Spurning the American Dream


Pursuing one’s medical career in the land of milk and honey— where the green bucks in compensation easily trump the pesos one can earn locally with longer hours of toil—can indeed be persuasively enticing. But finding meaning in one’s chosen vocation in one’s native land—where one becomes part of a cause far greater than enriching oneself—can be more rewarding


“When do you plan work in the United States?” This is a common question asked by friends and family. It was like a rite of passage, pursuing the American Dream. After all, it was a dream my family had once fought for.

Come to think of it, working and living in Manila can be tedious and exhausting. The daily traffic, the noise, the petty crimes on the streets, and unless you are among the elite super rich, you also worry about the small wages and skyrocketing cost of living.

During a recent blood drive by the Philippine General Hospital (PGH) Blood Bank at an exclusive condominium property, I met a Filipino retiree from Kaiser Hospital in California, USA. He migrated to the States in his mid-thirties to work as a medical technician, had a family and completed his employment for ten years, now retired and living a comfortable life back in the Philippines with a pension almost reaching six figures in Philippine peso every month.

Wow, I thought. It was not “too late” for me after all. I know a handful of physicians-some diplomates and even consultants who abandoned their practices in Tacloban to work as nurses in America. One of them told me, ”You can always return to Tacloban to practice medicine at your chosen time. While you are young, pursue your American dream.” His family migrated to the United States after super typhoon Yolanda struck Tacloban in 2013, and they perceived the migration secured their children’s future.

I can completely understand where they were coming from. A couple of months ago when I visited my brother in Florida, I can tell life was truly financially rewarding especially for the highly skilled professionals. Wages were excellent for registered nurses, and homes were built at a certain standard where wall-to-wall carpeting, fully furnished spaces were the norm. Services were excellent, and every conceivable item be it clothing, cosmetics, décor, gadgets, and groceries were available at fair price in malls and outlet stores. Best of all, if you are thrifty, the wages that you earn in dollars are bigger when converted to peso when you get home.

The simple life

It was nearly our mother Jennifer’s 9th death anniversary, and in the Catholic faith it was a significant occasion. I decided to visit my parent’s graves in Abuyog, Leyte. As I got into a tricycle in downtown Tacloban, a man suddenly asked me,

“Aren’t you Jennifer Hinunangan’s son?”

“Yes, Sir, I am.” I said.

“She helped me when my wife was hospitalized in Eastern Visayas Regional Medical Center (EVRMC),” he said.

I smiled to myself. I could not help but feel proud of my mother, who as a simple nurse served patients in the largest public hospital in our province. She had touched the lives of people, including this man who drove the tricycle. It was a good way to be remembered.

Spurning the American Dream 2It was total chaos as I got home that day with all the food ingredients for the meal after the novena. While our relatives cooked, I had my brother Tye fetch my stethoscope so I could examine our neighbors, who were mostly old ladies, complaining of the usual cough and colds and body aches.

These old ladies who are devoted to Our Lady of Fatima and Sacred Heart of Jesus, were friends of our late grandmother. They would spend each Sunday at a different house in our neighborhood to pray. They had seen me grow up and had been especially happy that I was now their “go-to” physician who can give free consultations and help them with their health problems.

I also visited EVRMC, where I had my clerkship as a medical student. My roots in this hospital are deep since my mother was among the pioneer nurses, and she had usually brought me with her during her duties in the Neonatal Intensive Care Unit. I visited the Department of Laboratories and got to talking about the challenges facing the department. We had too little applicants for residency in Pathology, and some services like Immunohistochemistry for diagnosing difficult cases of malignancies were still sent out to Manila. I realized, there was work to be done.

Higher ground

As I got back to Manila to continue with my residency training in PGH, I was facing a lot of challenges. First off, I had several conferences where I was a presenter, and being in front of consultants, fellows and residents was an unnerving experience. It was difficult to overcome. I also had slides to read, autopsies to do, and exams to take. Sometimes I ask myself, what for? I mean not even all doctors choose to specialize. Besides, there were no guarantees that it will all pay off in the end. Resident physicians do not earn a lot of money, and it is still a question mark if one will be able to put up a successful medical practice. And there also was the challenge of day to day living such as paying rent and bills.

I remembered what the retiree from Kaiser said, no matter how much effort you exert, whatever you earn here in the Philippines is nothing compared to what you will earn if you work in the United States. Even my brother who is a nurse, same as me, is obliged to work only three 16-hour shifts in a week. As a medical clerk before, I worked 36 hour shifts without pay. But still…

Every time I remember my patients during clerkship in EVRMC or internship in PGH—the downtrodden, the sick, those who could not afford proper health care—the service we provide them is priceless. The responsibility we have as a public servant in health care was sacred. I show up to these old hospital walls because I am needed here. Even the old ladies in my neighborhood needed me partly for their health needs.

Perhaps if I live and work in the States, I would be well-off and comfortable. The American Dream of big, beautiful houses and fine things. But what of my hometown? Do we push for the improvements of pathology and medical services or just hope that someone, someday will come to help move things forward. Leaving would solve my problems alone, but staying meant being part of a cause greater than myself. To the practical, I might look like a sentimental fool. A noble one at that, but a fool nonetheless.

“Leaving would solve my problems alone, but staying meant being part of a cause greater than myself”

September 2017 Health and Lifestyle

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